Psychiatric and Mental Health Commons^™

Seizure To Drug Induced Schizophrenia: A Rare Case Of Keppra-Induced Psychosis, Shadi Shams, Riddhima Issar, Nardin El-Shammaa, Munaza Khan

Rowan-Virtua Research Day

Levetiracetam is a broad-spectrum antiseizure medication and is approved as adjunctive therapy to treat focal-onset seizures in children and adults with epilepsy. Levetiracetam has a wide margin of safety and patient-friendly pharmacokinetics that distinguish it from other currently available antiepileptic drugs.

Most common side effects are fatigue, somnolence, dizziness, and upper respiratory infection. Neuropsychiatric symptoms are reported. Psychotic symptoms, paranoid ideation, hallucinations, and behavioral problems may occur in adult and pediatric patients. Among all adverse effects, the rate of psychosis is very low and ranges from less than 1% to 1.4%. A retrospective study showed that this rate is higher …

Effect Of Covid On Postpartum Depression (Ppd), Reshma Thomas, Karen Krieg, Joanna Petrides

Rowan-Virtua Research Day

Purpose:

1. To determine if the rates of postpartum depression have changed during COVID
2. To identify differences in characteristics of women with postpartum depression during COVID

Obsessions In Ocd Mimicking Capgras: A Case Report, Ricky Chu, Alexander Swartz, Helen Yi

Rowan-Virtua Research Day

Obsessive Compulsive Disorder (OCD) is a mentally debilitating condition that can present in a multitude of ways and its manifestations can vary within the diagnosed patient population. OCD can be diagnosed with the presence of either obsessions or compulsions and does not require both. Sometimes, OCD can affect a patient in a way that mimics delusional misidentification syndromes. In these cases, a patient's ego-dystonia can be a key distinguishing feature in diagnosis. In one specific delusional misidentification syndrome, Capgras, a patient possesses fixed beliefs that a known person (or sometimes object) is an imposter. And even though the textbook OCD …

Riluzole For Pediatric Patients With Treatment-Refractory Obsessive-Compulsive Disorder, Maheen Mohammad, Stuti Parikh

Rowan-Virtua Research Day

Obsessive-compulsive disorder (OCD) occurs in about 1-3% of the pediatric population, but many do not respond to standard therapies. Riluzole, a glutamate antagonist, has shown to be an effective treatment for refractory OCD in adults, however few trials have been conducted to show the effectiveness of Riluzole in children to treat refractory OCD. The study investigates the potential use of riluzole in children to treat refractory OCD.

The Effect Of Covid-19 On Depression In Hispanic Vs. Non-Hispanic Populations In South Jersey, Rana Cheikhali, Daniel Casal

Rowan-Virtua Research Day

The COVID-19 pandemic has been challenging for Americans and the world as a whole. It has especially taken a toll on mental health. Studies show that the incidence of depression in the United States was three times greater during the pandemic compared to pre-pandemic times. One specific community in the United States that has been greatly affected by the pandemic is the Hispanic American community. Many Americans across the country have received federal surveys that aim to determine the social and economic impacts of COVID-19. Results revealed that the Hispanic population had the greatest rise in mental illness, with 40% …

The Impact On Adolescent Mental Health In South Jersey Due To The Cancelation And Return Of Sports, Tara Pellegrino, Tara Young

Rowan-Virtua Research Day

Due to the Covid-19 pandemic, many organized sports programs have been canceled or limited in participation. While research prior to the pandemic has strongly suggested that participation in organized sports has benefits for mental and physical health, especially in adolescence, there have been minimal studies on how the removal of organized sports affects mental health outcomes. Additionally, studies have found that the stress of the pandemic and its associated life changes has greatly decreased mental health outcomes in our target population. These findings may indicate the importance of return to organized sports in a time where mental health outcomes are …

Analyzing The Effects Of The Covid-19 Pandemic On Mood Disorders In Patients, Alexa Golub, Joanna Petrides, Meagan Vermeulen

Rowan-Virtua Research Day

The COVID-19 pandemic brought about restrictions on social interactions, altered work settings/job losses, decreased access to groceries and essentials, and more

With strict prevention measures and isolating quarantine experiences, it was anticipated that the lockdown would have psychological effects

Some contributing psychological stressors included duration of quarantine, fear of infection, boredom, lack of supplies, inadequate information, and finances

This study aimed to quantify and evaluate any change in mood disorder diagnoses since the onset of the COVID-19 pandemic

Assessing The Impact Of The Covid-19 Pandemic On Adolescent Mental Health, Vanessa Pizutelli, Yanil Morales, Christina Copeland, Archana Salek

Rowan-Virtua Research Day

Adolescence is a crucial period in which adverse childhood experiences, social relationships, and habits can influence mental wellbeing. According to the CDC, the onset of mental illness is 14.5 years old, which is why it is imperative that individuals with mental health conditions receive early intervention. Since the start of the Covid-19 pandemic, research has shown a dramatic decline in adolescent mental health. Specifically in New Jersey, it has been reported that individuals ages 18-23 have the highest levels of stress and depressive symptoms since the start of the pandemic. In light of these findings, it is vital that more …

Bullous Pemphigoid With Excoriation Disorder In A 59 Year Old Woman, Kaitlin Mcgowan, Stephen Poos, Nguyen Vo

Rowan-Virtua Research Day

Bullous pemphigoid is the most common autoimmune blistering disease. Classic symptoms include blisters overlying urticarial plaques on the torso and extremities. The condition can result in intense pruritus that begins during the prodromal period.

Excoriation disorder is related to obsessive compulsive disorder (OCD) and is characterized by recurrent skin picking that results in lesions, repeated attempts to stop or decrease the picking, and resultant mental distress or impairment in functioning.

We present a case of a 59-year-old Caucasian female who presented with diffuse rash on most of her body. This particular case is notable for its concurrent severe dermatological and …

The Prevalence Of Postpartum Depression In Black And Hispanic Women In New Jersey, Courtney Chineme, Rachel Shmuts, Chris Canlas

Rowan-Virtua Research Day

Postpartum depression (PPD) is defined as symptoms of major depressive disorder (MDD) within one month of giving birth with the prevalence in the United States being 10-15%. There are well documented instances of racial differences and their effects on maternal outcomes including infant, maternal mortality and postpartum mood disorders. In New Jersey, there are monitoring systems that explore the relationships between maternal characteristics such as race, age, education level, insurance status, and racial bias and how they may correlate with higher incidences of Postpartum Depression (PPD) in these communities of women. The purpose of this comparative study is to analyze …

The Role Of Primary Care Physicians In Post-Partum Depression (Ppd), Elizabeth Bowman

Rowan-Virtua Research Day

Background

• Symptoms of depression lasting longer than 2 weeks following birth
• 10-15% of new mothers affected yet 50% of cases go undiagnosed
• Long-lasting consequences for the mother, baby, and father
• Multi-factorial condition

Conclusion

• Primary care providers are the first-line defense against PPD
• Many providers are resistant to PPD screenings
• Interventions from primary care providers are effective

A Terrible Prank Gone Horribly Wrong The Development Of Delusional Infestation As An Adjustment Reaction To A Traumatic Hoax, Timothy Wong, Nardin El-Shammaa, Munaza Khan, Stephen Scheinthal

Rowan-Virtua Research Day

Delusional infestation (DI) is a somatic type delusional disorder, characterized by a fixed belief that one is infested by living or nonliving pathogens (1,3) . DI is a relatively rare disorder (4,5), with an estimated 20-80 cases per million people annually (6). Effective management of patients suffering from DI is crucial, as patients may cause significant harm to themselves in their attempts to remove the pathogens (7,8). Regarding treatment options, antipsychotic medications such as pimozide and risperidone have been promising (8,10). However, there remain many barriers to care (11), and patients are hardly ever seen in psychiatry as they preferably …

Mental Health Outcomes At A Student-Run Free Clinic, Jessica-Sophie Horoschak, Riya Tandra, Sahil Parikh, Shayna Peterzell, Roma Padalkar, Tara Pellegrino

Rowan-Virtua Research Day

In this project we aim to:

1. Assess the outcomes of screening, management, and diagnosis for patients at the Rowan Community Health Center (RCHC).

2. Compare the outcomes of screening, management, and diagnosis between different groups (gender, race, income, insurance status) using validated surveys.

3. There is a need for accessible and affordable primary care in the South Jersey area, which the RCHC is hoping to meet.

Hypothesis:

The quality of mental health care available to patients at the RCHC is comparable to that at other insured practices.

Case Of New Onset Alice In Wonderland Syndrome In Adolescent After Prolonged Hospitalization, Michaela Margolis, Timothy Wong, Richard Hadi

Rowan-Virtua Research Day

Alice in wonderland syndrome (AIWS) has been described as body image illusions involving distortions of the size, mass, or shape of the patient’s own body or its position in space, often occurring with depersonalization and derealization. Most cases typically affect young children.

Common distortions are micropsia, macropsia, metamorphopsia, and pelopsia.

The term was adopted from the book by Lewis Carroll, wherein the main character perceived her size and shape to change in different scenarios.

These distortions are often expressed as sensory perceptions rather than illusions or hallucinations, and are often distressing to the patient.

AIWS onset has been found to …

Development And Presentation Of A Lesson On Mental Health For High School Students During The 2021 Covid-19 Pandemic, Daniel Yang, Sana Farhat, Jhocelin Morquecho, Rutva Patel, Rui Shi, Md Fateha, Mary Duggan

Rowan-Virtua Research Day

With the support of the HRSA, the Health Careers Opportunity Program (HCOP) was established to increase the number of students from underrepresented backgrounds to pursue careers in healthcare. HCOP combines the efforts of high school, undergraduate, and medical students in creating an original project to serve a need within the community. In this HCOP project, we aim to address the issue of mental health with high school students at two New Jersey high schools: Pennsauken and Williamtown.

Acute Flecainide Toxicity Treated With Intravenous Lipid Emulsion, Joseph S. Schreiner

Rowan-Virtua Research Day

Flecainide is a Vaughn-Williams class IC antiarrhythmic used in the treatment of supraventricular tachycardias including atrial fibrillation. While overdose is rare, its negative effects on cardiac inotropy and conduction pathways can be readily fatal. This is further complicated by the redistribution of the drug out of the plasma and deposition in tissue, rendering reversal by sodium bicarbonate (the standard first line treatment agent) relatively ineffective. A case study of the successful treatment of hemodynamic collapse using sodium bicarbonate in conjunction with intravenous lipid emulsion (ILE) in a patient who ingested a large amount of flecainide in a suicide attempt will …

A Holistic Approach To Physical And Mental Health: Associations Between Chronic Disease And Psychiatric Conditions, Pooja Patel, Alison Mancuso

Rowan-Virtua Research Day

OBJECTIVE:

• To investigate the link between chronic medical conditions and psychiatric disorders

BACKGROUND

• Limited research has been done studying the relationship between chronic medical conditions and psychiatric disorders in patients comorbid with both types of conditions.

• Prior research studies have demonstrated that patients with chronic medical conditions are more likely to develop psychiatric disorders compared to healthy individuals without any medical conditions.

• As individuals develop chronic medical conditions, they may encounter additional obstacles in their lives,

Alzheimer's Patients’ Mental Health During The Covid 19 Pandemic, Maryanna Schweininger, Yvonne Maduka, Ajh'shana Collins

Rowan-Virtua Research Day

Alzheimer’s disease (AD) is a degenerative brain disease caused by β Amyloid plaques and neurofibrillary tangles, which results in memory loss and cognitive decline. It is the sixth leading cause of death in the United States. Approximately 50% of those with AD experience some degree of depression during the course of the disease, which has been shown to accelerate functional decline, institutionalization, and even mortality.

Many who cannot care for themselves live in an assisted living facility or retirement home. Since the beginning of the COVID 19 pandemic, people have been urged to social distance in order to decrease the …

Establishing A Resident-Lead High School Outreach Program To Improve Physician Community Engagement, Dylan Mcdivitt

Rowan-Virtua Research Day

New Jersey’s Cumberland County is home to a vastly diverse population of people, comprised of numerous racial, ethnic, economic, health, and educational backgrounds among its nearly 150,000 residents. Per U.S. Census data, about 15% of the population is below the poverty line, including about 20% of those below the age of 18. With economic hardship often come health problems and disparities, and Cumberland County’s rates of obesity, tobacco use, lung cancer, and drug-induced deaths are all above the national averages.

Notable student survey findings:

• 67 students reported a friend had shared thoughts of depression with them in the last …

Affective Disturbance In Mild Cognitive Impairment, Jason Greenhagen, Emily Matusz, Sheina Emrani, David Libon, Sherry Pomerantz

Rowan-Virtua Research Day

Mild cognitive impairment (MCI) is an identifiable, prodromal stage of cognitive impairment and has been further defined into subtypes: amnestic, language, executive functioning, and multi domain/mixed MCI (Jak et al. 2009 ). The purpose of this study is to (1) examine the differences in depression, anxiety, and apathy between MCI subtypes; and (2) assess the relationship between the neurocognitive domains (executive functioning, language, and memory and affective symptoms. We hypothesize that apathy will be greater in dysexecutive/mixed MCI (dys/mixed MCI) and be more highly correlated to neurocognitive deficits compared to depression or anxiety. This is a retrospective study of 113 …

Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides

Rowan-Virtua Research Day

• To address whether primary care physicians and pediatricians are equipped to recognize the prodromal symptoms of psychotic disorders

• Patients of primary care physicians exhibited increased help seeking behaviors prior to schizophrenia diagnosis [1]

• Primary care physicians in numerous countries have shown a lack of sufficient knowledge related to diagnosing and treating schizophrenia [2,3,4,5,6]

• Unclear if primary care physicians in the United States are adequately trained and prepared to recognize prodromal signs of schizophrenia, and diagnose and treat a variety of psychotic disorders

Mental Health Symptom Severity In Cannabis-Using And Non-Using Veterans With Probable Ptsd, Matthew J. Johnson, John D. Pierce, Shahrzad Mavandadi, Johanna Klaus, Diana Defelice, Erin Ingram, David W. Oslin

Rowan-Virtua Research Day

BACKGROUND:

Posttraumatic Stress Disorder (PTSD) is a disabling illness suffered by many veterans returning from war. Some veterans believe that cannabis may be therapeutic for PTSD. The purpose of this study was to better understand the association between cannabis use and PTSD symptoms.

METHODS:

The study was a matched case-control cross-sectional evaluation of the psychiatric and sociocultural associations of cannabis use in veterans with probable PTSD. Patient self-report measures were examined comparing cannabis users (cases) to non-users (controls) who were case-matched on age and gender.

RESULTS:

Results indicated that there were no significant differences between cases and controls in mean …

Omt For The Treatment Of Depression And Anxiety, Zachary Winchell

Rowan-Virtua Research Day

Osteopathic manipulative therapy (OMT) fundamentally aims to remedy somatic dysfunction through the manipulation of the patient. In this regard, OMT is a particularly viable non-pharmacological adjunct for patients with depressive and generalized anxiety disorder (GAD).

In both of these disorders, the hypothalamic-pituitary-adrenal axis has an interdependent relationship with physiological stress that feed one another to both increase symptomology and leave patients vulnerable to negative life events. Additionally, pro-inflammatory cytokines acting on the brain over long periods of time can lead to exacerbation of disease and the development of depression in susceptible individuals. Altered cytokine balance has also been found in …

Prefrontal Corticotropin-Releasing Factor (Crf) Neurons Act Locally To Modulate Frontostriatal Cognition And Circuit Function., Sofiya Hupalo, Andrea J Martin, Rebecca K Green, David M Devilbiss, Craig W Berridge

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The PFC and extended frontostriatal circuitry support higher cognitive processes that guide goal-directed behavior. PFC-dependent cognitive dysfunction is a core feature of multiple psychiatric disorders. Unfortunately, a major limiting factor in the development of treatments for PFC cognitive dysfunction is our limited understanding of the neural mechanisms underlying PFC-dependent cognition. We recently demonstrated that activation of corticotropin-releasing factor (CRF) receptors in the caudal dorsomedial PFC (dmPFC) impairs higher cognitive function, as measured in a working memory task. Currently, there remains much unknown about CRF-dependent regulation of cognition, including the source of CRF for cognition-modulating receptors and the output pathways modulated …

Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS: Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS: In total, 7% (107) of respondents reported they experienced …

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Departmental Research

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

The Influence Of Therapist-Patient Religious/Spiritual Congruence On Satisfaction With Therapy: A Review Of Research, Tammy E. Henderson

Theses and Dissertations

The goal of this review was to examine the relationship between mental health and religion and/or spirituality. Specifically, it was believed that religion and spiritual congruence had a positive influence on satisfaction with therapy. Indeed, the literature reviewed suggests that therapists should be more open to addressing a patient's religious and/or spiritual beliefs as it could lead to more attuned therapeutic sessions. The importance of congruence between patient and therapist is a factor that can impact the therapeutic alliance, based on the literature, this concept appears to hold true for those that are or are not religiously and/or spiritually inclined.

Implementation Climate And Time Predict Intensity Of Supervision Content Related To Evidence Based Treatment, Michael D Pullmann, Leah Lucid, Julie P Harrison, Prerna Martin, Esther Deblinger, Katherine S Benjamin, Shannon Dorsey

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Objective: Children infrequently receive evidence-based treatments (EBTs) for mental health problems due to a science-to-practice implementation gap. Workplace-based clinical supervision, in which supervisors provide oversight, feedback, and training on clinical practice, may be a method to support EBT implementation. Our prior research suggests that the intensity of supervisory focus on EBT (i.e., thoroughness of coverage) during workplace-based supervision varies. This study explores predictors of supervisory EBT intensity. Methods: Participants were twenty-eight supervisors and 70 clinician supervisees. They completed a baseline survey, and audio recorded supervision sessions over 1 year. Four hundred and thirty eight recordings were coded for supervision content. …

Suicidal Ideation Assessment In Individuals With Premanifest And Manifest Huntington Disease., Melissa Wesson, Nicholas R Boileau, Joel S Perlmutter, Jane S Paulsen, Stacey K Barton, Michael K Mccormack, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease (HD) is associated with increased risk of suicide.

OBJECTIVE: This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation.

METHODS: We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S. …